Significant Upcoding Risks Emerge with Medicare Advantage

significant upcoding risks emerge with medicare advantage

Christi Grimm, the Inspector General of HHS, gave a recent keynote address to compliance professionals. In it, she said, “Simply put, the financial incentives created by risk adjustment may be driving upcoding in the severity of diagnoses to garner additional payments.”

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Preparing for the End of the Public Health Emergency

Changes to PHE waivers for Medicare and Medicaid beneficiary patients YouCompli

Changes to PHE waivers and recommendations for hospitals. Compliance must assist and advise on policy, process, contractual, and operational changes by May 2023.

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